Endometrial hyperplasia and bleeding; letrozole in gestagen failure?

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Ibrahim Elbahloul
 

Jouf University KSA, Egypt

: J Womens Health, Issues Care

Abstract

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Background: Endometrial hyperplasia an important risk factor for the development or even co-existence of endometrial cancer. Geatagen failure is defined as progression to atypical hyperplasia, no histological regression of hyperplasia despite 12 months of treatment, relapse of endometrial hyperplasia after completing hormonal treatment, or persistent bleeding. Patients and methods :A total of 46 women diagnosed with simple endometrial hyperplasia without atypia with failed gestagen therapy (for at least one year) were enrolled. They were randomly assigned to either: Group A included 20 patients who received letrozole (Letrozole Tablets, Synthon Pharmaceuticals, Inc.) in a dose of 2.5 mg daily for 3 months by non-stop regimen. Group B included 20 patients who received letrozole; in a dose of 5 mg daily (2.5mg twice daily) for 3 months by non-stop regimen. Results: Complete resolution occurred in 17 patients in group A (89.5 %) and 17 patients in group B (94.4 %). Static disease occurred in 3 patients, 2 from group A (10.5 %) and 1 patient from group B. These 3 patients were advised to continue on the same regimen for another 3 months, one of them (from group A) underwent hysterectomy on her own request, and also the other two patients did not improve after that and underwent hysterectomy Conclusion: Patients with simple endometrial hyperplasia without atypia with failed Gestagen therapy can be managed successfully with Letrozole. Both dose regimens used succeeded in management of simple endometrial hyperplasia without atypia with no significant difference between them as regard the clinical, radiological or histological outcome. However, the second dose group B (5 mg) was associated with higher side effects, failure rates, cost and less patient compliance, so, group A (2.5 mg) is preferred, however further RCT are warranted to prove or disprove this.

Biography

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Ibrahim Elbahloul is an esteemed expert in obstetrics and gynecology, currently affiliated with the Department of Obstetrics and Gynecology at Mansoura University in Egypt and Jouf University in Saudi Arabia. With a focus on endometrial hyperplasia and its management, Dr. Elbahloul's research investigates the efficacy of letrozole in cases of gestagen failure. His contributions to the field are marked by a commitment to advancing women's health through innovative treatment strategies and rigorous scientific inquiry. Dr. Elbahloul's work aims to enhance understanding and management of endometrial disorders, benefiting patients across diverse populations.